Cat-scratch encephalopathy presenting as status epilepticus and lymphadenitis

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Neuroimmunology

Background:

• Cat-scratch disease, caused by Bartonella henselae, is a common zoonotic infection.
• Neurological complications, including encephalopathy, can occur in children with cat-scratch disease.
• Status epilepticus is a rare but serious neurological manifestation.

Purpose of the Study:

• To describe a case of cat-scratch encephalopathy presenting with status epilepticus in a child.
• To highlight the diagnostic challenges and clinical course of this condition.
• To emphasize the importance of early recognition and treatment.

Main Methods:

• Case report of a five-year-old male with generalized seizures and lymphadenopathy.
• Diagnostic workup included history, physical examination, lymph node biopsy, and skin testing.
• Neurological assessment involved serial brain CT scans and lumbar punctures.
• Treatment involved anticonvulsant therapy.

Main Results:

• Diagnosis of cat-scratch disease confirmed by clinical, histopathologic, and skin test findings.
• Patient experienced recurrent status epilepticus refractory to standard treatment.
• Prolonged encephalopathy with symptoms like confusion, hemiparesis, tremor, chorea, and vomiting.
• Complete neurological recovery without sequelae within nine months.

Conclusions:

• Cat-scratch encephalopathy should be considered in children with status epilepticus and lymphadenopathy.
• Aggressive and prolonged anticonvulsant therapy is recommended for refractory seizures.
• Early diagnosis and management are key to favorable outcomes in pediatric cat-scratch encephalopathy.